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Silent pandemic' sweeps poor states
Global health projections leave little doubt that chronic diseases are
rapidly overtaking infectious diseases as the world's biggest killers
Publish Date: Monday,25 January, 2010, at 11:32 PM Doha Time
By Kate Kelland/London
A "silent pandemic" of chronic disease is creeping up on poor countries
and will force pharmaceutical firms to take a more tiered approach to pricing
some of their most lucrative medicines.
Drugs for diseases which were previously dominant only in the rich,
well-fed world, such as diabetes, heart disease and cancer, are increasingly in
demand in poorer nations in Asia and Africa, whose populations are now living
longer.
But the price of many of these medicines and their unsuitability for
emerging markets are high barriers to access.
And yet unless those hurdles are overcome, experts say, chronic diseases
could swamp developing health systems and kill many millions - and the hopes of
drugmakers like GlaxoSmithKline, Pfizer and Sanofi-Aventis of supplying vast
new markets in emerging economies will struggle to come to fruition.
Discounting prices for poorer countries, a move already made by some big
drug firms, is a start. But pharmaceutical bosses will also be under pressure
to join patent pools to promote downward price pressure on drugs for major
chronic diseases by increasing the number of producers, and may face legal
challenges to force them to allow in more generic competition.
"Until now companies had been able to separate out drugs that are needed
in developing countries from drugs that primarily make up their market in rich
countries," Tido von Schoen-Angerer, director of Medecins Sans Frontieres'
campaign for access to essential medicines, told Reuters in an interview.
"But the divide which saw infectious diseases as primarily affecting the
poor and chronic diseases affecting the rich is now changing, and that will
demand a change of strategy."
Global health projections leave little doubt that chronic diseases are
rapidly overtaking infectious diseases, such as malaria, Aids and tuberculosis
(TB), as the world's biggest killers - a shift emphasised by a recent World
Health Organisation (WHO) report on global health risks.
It said populations are ageing partly due to success against infectious
diseases, and changing patterns of food, alcohol and tobacco consumption are
creating a "double burden" for poor nations, piling chronic diseases on top of
infectious diseases.
The World Economic Forum's 2010 global risks report, published ahead of
its annual meeting in Davos, characterised the shift as a "silent pandemic".
It said that while deaths from infectious diseases, maternal conditions
and poor nutrition will fall by 3% in the next decade, deaths from chronic
disease will increase by 71%. Cases of diabetes, heart disease and stroke, for
which major weight gain is a big risk factor, are predicted to rise rapidly as
the obesity epidemic takes hold in the developing world. Diabetes, which the
WHO says accounts for 5% of all deaths globally, with around 80% in developing
nations, is seen rising by 42% from 2005 levels by 2015 in Africa, and by 39%
in the same time frame in southeast Asia.
Cancer is already a bigger killer in developing countries than TB,
malaria and Aids combined and experts see a doubling of global cancer cases in
the next 20 years. WHO expert Colin Mathers says the shifting disease burden
is the price of success against big killers, such as malaria and Aids.
"Because people are living longer, they're living to ages where chronic
diseases are an increasing problem," he said.
Some pharmaceutical firms are already making moves to cut drug prices for
poorer people, hoping to smooth access to faster-growing emerging markets - and
make up for sluggish growth in markets like the United States, Japan and
Europe.
GlaxoSmithKline and Sanofi-Aventis have both promised to cut prices in
some developing countries.
Sanofi says drugs like Lantus for diabetes and cancer treatment Taxotere
will be as low as half price in some southeast Asian nations like Indonesia and
the Philippines.
Glaxo has promised to discount patented drugs in the poorest countries to
no more than a quarter what they cost in the rich world and its chief
executive, Andrew Witty, said on Wednesday the firm was "committed ... to a
tiered pricing approach". Glaxo, Sanofi and other drugmakers, including
Pfizer, also plan to sell their own generics to capture business in emerging
markets using cheaper versions of drugs now going off patent.
MSF's von Schoen-Angerer still says more innovative strategies - such as
extending drug patent pools like one set up by the international health funding
agency Unitaid for Aids drugs last month - are needed if real progress is to be
made on getting chronic disease drugs to the poor.
Developing nations may choose to take legal steps to beat down
high-priced drugs, he said, like authorities in Thailand did in 2007 with a
compulsory licence system allowing local generic makers to override patents on
some HIV/Aids drugs.
He also said greater "adaptive innovation" is needed from drug firms to
make their medicines suitable for poorer nations.
"That might mean a new and different combination of pills, or adapting
diagnostic tools to make them easier and cheaper to use in resource-poor
settings," he said. "But it can't just be about taking the medicines we have
from A to B." - Reuters
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